Geriatric Medicine

The clinics offer comprehensive geriatric assessment services for elderly patients through multiple referral pathways, accepting cases from both private and public primary care clinics as well as specialist medical services. Additionally, the clinics receive referrals from acute care settings such as the Emergency department, and from care facilities including community hospitals and nursing homes, ensuring broad accessibility to specialised geriatric care.

Each patient undergoes thorough evaluation encompassing medical, functional, and social domains to provide a holistic understanding of their health status and care needs. This multidimensional assessment approach enables the development of comprehensive care plans that address not only medical conditions but also functional limitations and social circumstances that significantly impact elderly patients' overall wellbeing and quality of life.

The Continence Clinic provides assessment and diagnosis for persons with bladder or bowel problems such as urinary incontinence, difficulty in passing urine, excessive urination at night, constipation or other bowel problems.

Continence specialist nurses also provide education on good bladder and bowel habits, intermittent self-catheterization or management of indwelling urinary catheters.

Working together with urologist, we form a personalised plan of care including toileting programmes, pelvic floor exercises, bladder retraining, continence aids or medications will be provided to restore Continence.

The Falls and Balance Clinic aims to reduce fall risk for older persons by identifying and correcting risk factors.

This starts with a comprehensive functional (visual, sensory, reaction time, mobility), and physiologic profile (muscle strength and balance) assessment together with a review of relevant health issues.

We also work closely with physiotherapist to discuss and prescribe strengthening and balance exercise or group exercise programmes according to the individual's need.

Who will benefit from the Falls and Balance Clinic?

If you are above 65 years old, able to walk and

• fell more than twice in the past 12 months, or
• persons who observe your walking are concerned that you might fall, or
• have a significant fear of falling based on these questions:
  • Do you avoid going out or restrict your routine activities because you are afraid of falling?
  • Do you feel like you are going to fall on getting up or walking?

If the answer is "Yes", do discuss with your polyclinic doctor or GP on obtaining a referral.

Frailty is recognised as a lens through which all patients and diseases are viewed, especially in Geriatric Medicine as it can be reversed in early stages.

For patients with potentially reversible frailty, frailty classes by a team of physiotherapist, dietitian and geriatrician are available in the Specialist Outpatient Clinic to restore strength, provide nutritional advice, optimise chronic disease management and provide preventive therapeutic options.

This service operates a specialised memory clinic dedicated to the comprehensive assessment and ongoing management of patients presenting with cognitive impairment and dementia-related concerns. The clinic provides thorough evaluation of cognitive decline, including detailed assessment of functional capabilities and behavioural manifestations that commonly accompany dementia and other neurocognitive disorders.

The memory clinic employs a multidisciplinary team approach to ensure holistic patient care, bringing together expertise from doctors, nurses, psychologists, medical social workers, and various therapists. This collaborative model enables comprehensive evaluation and tailored treatment plans that address not only the medical aspects of cognitive impairment but also the psychological, social, and functional challenges faced by patients and their families throughout the disease progression.

The ECI service runs an enhanced clinic that provides assessment and management of patients with mild cognitive impairment or early dementia. A multidisciplinary team consisting of geriatricians, neurologists, radiologists, nurses, psychologists, dieticians, medical social workers and therapists provide care for the patients of this clinic. Suitable patients will be admitted electively for disease modifying therapy.

Perioperative care is the practice of patient-centered, multidisciplinary and integrated medical care of patients from the moment surgery is considered until full recovery. For older adults with complex medical needs and geriatric syndromes, geriatrician is uniquely positioned to coordinate this care. By working closely with surgical teams, we help ensure that even frail older patients can safely benefit from expanding range of treatment options.

The clinic provides specialised geriatric care for patients aged 78 and above who present with acute medical conditions requiring prompt specialist assessment. These patients are referred directly from the Emergency Medicine department and GSSW, ensuring seamless transition from acute care settings to appropriate geriatric medicine follow-up.

All referred patients receive comprehensive review by a specialist geriatrician within one to 14 working days of referral, facilitating timely access to expert care. The clinic's focus on preventive medicine and early intervention strategies helps optimise health outcomes for elderly patients, addressing age-related complexities and preventing potential complications through proactive geriatric assessment and management.

Palliative Care is dedicated to enhancing quality of life and bringing comfort to patients and their families navigating advanced progressive illnesses. Our approach focuses on comprehensive, compassionate support that addresses physical, emotional, and spiritual wellbeing through expert symptom management and holistic care.

Our skilled team of doctors, nurses, allied health professionals, pharmacists, social workers, psychologists, and psychiatrists work together to provide personalised, integrated care that includes effective symptom relief for concerns such as pain and breathlessness, clear communication and dedicated support for patients and families, thoughtful guidance for important medical decisions, collaborative advanced care planning, flexible care arrangements across various settings including home, community hospitals, hospices, and nursing homes, dignified end-of-life support, comprehensive psychosocial and spiritual care, and compassionate grief and bereavement assistance.

This collaborative approach ensures that every patient receives the specialised attention and support they deserve, empowering families with the resources and guidance needed during challenging times.

This clinic provides follow-up care for medically stable patients discharged from inpatient settings who require ongoing rehabilitation physician supervision, whilst also accepting new patients requiring rehabilitation medicine assessment and management. It serves as a bridge between hospital-based care and community living, ensuring continuity of specialised rehabilitation medicine support during the recovery process for both discharged inpatients and new referrals.

The clinic specialises in comprehensive spasticity management through a combined approach of physiotherapy interventions and botulinum toxin injections. This integrated treatment model addresses muscle stiffness and movement limitations, helping patients achieve improved functional outcomes and enhanced quality of life through targeted therapeutic interventions.